Our interactive CD-ROM program will address the deficiencies among medical trainees in their recognition of important cardiovascular abnormalities by physical examination. These deficiencies have been attributed to lack of exposure to structured teaching in medical schools and the lack of availability of inpatients representing an appropriate spectrum of cardiac conditions because of the shift to brief patient encounters in an ambulatory care environment. Our program will provide convenient exposure to a wide range of patients as well as skills testing. Our recorded audiovisual depictions of actual patients with pathological physical findings can be correctly diagnosed by integration of visible and audible phenomena. This new project will employ animated video graphics that were not technically possible to display on mid-priced computers until this time and will supplement our previously produced CD-ROM program by providing testing at multiple skill levels. By utilizing a cross-platform CD-ROM format and actual data it will provide a more realistic and less expensive alternative to the patient simulation devices now on the market. PROPOSED COMMERCIAL APPLICATIONS: The ultimate commercial goal is to produce a multimedia program to be sold through a publisher or distributor, with medical schools and teaching hospitals as our primary market. Potential customers range from the end user--medical students, residents, fellows, physicians seeking continuing medical education (CME), and nurses--to the teaching institution.